The County of Riverside’s Human Resources Temporary Assignment Program (TAP) is seeking a Bilingual(Spanish) Temporary Patient Services Coordinator to supportRiverside University Health System (RUHS) in Moreno Valley. Under minimal supervision, performs a variety of administrative and clerical duties in support of the Riverside University Health System (RUHS) Managed Care or Care Management program; and performs other related duties as required.
Depending on area of assignment, the Patient Services Coordinator reports to either the Nurse Coordinator, Director of Nursing Services, or an appropriate Revenue Cycle Manager. The Patient Services Coordinator class is primarily responsible for coordinating patient care at the RUHS ambulatory clinics or for coordinating referrals generated with contracted Managed Care Plans, both public and private. In addition, this class coordinates with physicians and mid-level providers regarding patient care or IPA's for all patients scheduled for appointments at RUHS, and obtains all authorizations necessary for patient care.Meet the Team!
Riverside University Health System-Medical Center consistently receives national recognition for its progressive and innovative care, as well as being known as one of the top employers in the region. The 439-bed Medical Center is a designated Stroke Center, Level II Trauma Center, and the only Pediatric ICU in the region. Can you see yourself here? For more information on RUHS-Medical Center, please visit:www.ruhealth.org.
About TAP:
The Temporary Assignment Program (TAP) recruits and hires temporary employees for all County departments. TAP assignments are a great way to learn about working for the County while working on a temporary, at-will basis.
Click here to learn more about TAP: https://rc-hr.com/temporary-medical-assignment-program-tapmap
TAP Benefits: https://rc-hr.com/files/users/user81/2024 TAP Flyer.pdf(Download PDF reader)(Download PDF reader)
• Assist physicians and other healthcare providers by providing care coordination to ensure patients receive optimal care; interact with Primary Care Providers, Specialty Providers, and other healthcare staff to coordinate care for patients.
• Liaison between healthcare staff and patients regarding maintenance of care and treatment; work closely with Providers to ensure continuity of care and treatment; facilitate communication among patients, physicians, nurses, and other healthcare staff regarding their care, including making appointments, treatment authorizations and resource needs.
• May assist with patient referrals to appropriate community resources; may provide patient education.
• Daily management of referrals which includes, input of data into manage care system, verify member eligibility, provider participation, and tracking of pending referrals.
• Authorize Treatment Authorization Requests (TAR) for the County of Riverside Medically Indigent Services Program (MISP); coordinate Durable Medical Equipment (DME) for all Managed Care Health Plans, public and private, coordinating quotes and equipment availability.
• Assist with transfer of patients to and from RUHS Medical Center and Care Clinics and other outlying hospitals for specialized care; verify patient eligibility with associated health plans.
• Coordinate with contracted IPA's and return copies of all appropriate clinic, surgery, and emergency room progress notes; process and authorize all requests for pharmacy that are not covered in the Drug Formulary.
• Request and review all emergency room notes for managed care patients that are seen through the Emergency Department; ensure return of all notes (i.e., outpatient, surgical, and emergency) to appropriate PCP or IPA.
• Coordinate patient transfers to other facilities for higher-level of care; coordinate with Medical Social Workers to facilitate care for patients; assist patients in qualifying for Medi-Cal or other programs.
• Process Third Party claims by determining and supplying information to and from attorney respective of patient's eligibility at the time of an accident.Education: Graduation from high school or possession of a Certificate of Proficiency issued by the California State Board of Education, or attainment of a satisfactory score on a G.E.D. test.
Experience: Three years of increasingly responsible, broad and varied clerical experience, at least one year of which included working in a managed care, healthcare, or behavioral health setting. For the RUHS care management program, experience as a Licensed Vocational Nurse or experience equivalent to the County of Riverside Behavioral Health Specialist I class is preferred.
Knowledge of: Rules and regulations pertaining to the confidentiality of medical information from federal, state and county agencies; medical terminology and basic laws of healthcare facilities and hospitals; federal, state and county regulations related to healthcare compliance.
Ability to: Interpret medical information, diagnosis and apply medical guidelines; communicate effectively orally and in writing; maintain effective working relationships with a wide variety of individuals; work independently, as well as in a team environment; operate a variety of telephone technology systems; understand the capabilities and applications of information processing equipment, considering the requirements of the program; utilize motivational interviewing skills; work efficiently in a fast paced environment; provide excellent customer service.Other Requirements:
Bilingual (Spanish)
Skills: Computer literate; ability to type 40 wpm. Comfortable with Microsoft Excel
Desired experience/education above the minimum requirements: At least 1 year experience in a healthcare setting working with referrals and authorizations.
This recruitment is open to all applicants.
For questions regarding this requirementContact Dawn Martin at 951-955-0643 or at dawmartin@rivco.org. For General inquiries, please allow up to two business days to receive a response.Based on the number of applications received this posting may close early with or without notice.
